Senate reverses health care cuts

In a compromise with the House, state senators restore funding for programs such as Medically Needy and prenatal care for poor women.

By ALISA ULFERTS
Published April 18, 2004

TALLAHASSEE - Some of Florida's sickest, poorest residents got a reprieve Saturday when the state Senate abruptly agreed to restore some of the deep social service cuts it had proposed for the state budget.

About $80-million of the $300-million the Senate proposed cutting will be added back to preserve such major programs as prenatal care for poor pregnant women, the Medically Needy program that serves severely ill patients without insurance and dental care for indigent elderly.

The agreement was a compromise with the House, which had proposed more money for social services.

The money to pay for these programs will be squeezed out of the budgets of the community college and state university system, as well as from trust funds throughout the state government.

It's just the kind of budget remedy the Senate had been fighting all along. In agreeing to restore the social service programs, the Senate abandoned its position that funding such programs with a patchwork of one-time sources such as grants and federal surpluses was a fiscally dangerous way for the state to do business.

But Senate president Jim King, R-Jacksonville, defended Saturday's plan, saying the Senate agreed to go along one last time because he believes Gov. Jeb Bush has a way to fix the problem for the long term.

"None of us - none of us - were happy with the cuts that had to be made," King said.

King said he hopes funding this year's budget will give Bush the time he needs to persuade the federal government, led by his brother President George W. Bush, to let Florida cap its Medicaid spending next year.

The state-federal health care program for the poor has doubled in size in the past six years in Florida and has become a huge strain on many states' budgets.

"We really feel, that with Jeb's help, there will be Medicaid reform in the coming year," King said.

Bush has already announced his intention to make Florida a pilot project for ending Medicaid as an entitlement program by capping spending at a fixed amount that is easier to predict. Next year Florida will spend almost $14-billion on the program, which is a mix of numerous health care services.

Fewer than half of the Medicaid programs Florida offers are required by federal law, but the state must make them available to everyone who qualifies if it wants to provide them at all. Both Medically Needy and the prenatal service the Senate wanted to cut were optional programs under Medicaid.

Bush wants to change the rules so states have more control over who gets services and how they get them. But it will take federal approval and it would end the guarantee of coverage.

That could make people like Tiffany Reid even more vulnerable to the spending whims of future Legislatures than she is now.

"It's a huge relief for this year," said Reid, a 32-year-old Bradenton mother with cystic fibrosis, who wouldn't be able to afford the lung transplant she needs without the Medically Needy program that was just spared for another year.

Medically Needy, which serves 27,000 severely ill people who can't get insurance, also pays for the prescriptions that keep Reid alive while she waits for a donor. Reid and her husband had already divorced so she could still qualify as a single mother of three if the program had been reduced by budget cuts.

Saturday was the second day of the joint House-Senate budget negotiations, which are expected to last about a week. The unexpected agreement on social services spending removes a substantial hurdle that had divided the two chambers.

Mary Ellen Ross is the executive director of the Florida Transplant Survivors Coalition, which formed in 2001 when lawmakers first began talk of cutting Medically Needy.

Many of the people in Ross' group rely on Medically Needy to pay for their organ antirejection drugs, which can run as high as $3,000 a month.

"I want to cry," Ross said when she heard the Senate had agreed to add the program back in.

"I think it's marvelous. I think they are finally realizing that we are human and that this program is sorely needed by thousands of people across the state," Ross said.

In its budget, the Senate proposed to gut the program and replace it with a prescription-only plan. No longer would doctors' visits, hospitalizations and surgeries have been covered.

The other major controversial cut in the Senate budget - now restored - would have cut prenatal care for about 7,000 poor pregnant women across the state by reducing the eligibility for the care from 185 percent of federal poverty level to 150 percent.

King said the Senate agreed to trim the budgets of the community college and state university systems, as well as skim the top off trust funds throughout the state, to come up with the money to restore the cuts.